Automated Insurance Verification for a Stealth HealthTech Startup

HealthTech startup building automation tools for medical practices. The company solves critical administrative issues: the daily manual verification of patient insurance coverage, which consumes staff hours and leads to revenue leakage through denied claims.

Before every visit, the front desk at an eye care practice has to verify insurance: active policy, coverage, today’s copay. Staff check each one manually through insurer portals or phone holds, often reading through a dozen pages just to find the copay. One misspelled name or expired card breaks the check, and the practice ends up with a denied claim or a surprise patient bill.

We built an AI-powered platform that runs insurance verification in the background. The system pulls the upcoming schedule from several practice management systems and verifies coverage through Stedi and other insurance portals before the visit. An agent then reads the full benefits response, often dozens of pages, and returns the numbers staff actually need: what the patient owes in-network and out-of-network. When patient details are wrong, the system texts the patient for a photo of their insurance card, corrects the information, and re-runs the check. Staff step in only for cases the platform can’t resolve on its own.

The platform now runs ~10,000 benefit checks a month in production. One practice cut the time spent on patient benefits from 8–11 hours a week to 1–2. In the owner’s words: “Your platform is the one thing that is probably keeping my sole front desk person’s head above water.“